| Objective:By retrospectively analyzing the relevant data of peritoneal dialysis patients included in this study,we explored the cardiovascular events of peritoneal dialysis patients and the risk factors affecting their survival rate,guiding clinical treatment and improving prognosis.Method:Select patients who were diagnosed with stage 5 chronic kidney disease from June 2010 to June 2019 and had undergone peritoneal dialysis catheterization in our hospital.The research object is patients who have undergone relevant tests and examinations(including cardiac color Doppler ultrasound and electrocardiogram)in our hospital before peritoneal dialysis surgery and more than 6 months after surgery.Collect general clinical data,laboratory data,color Doppler ultrasound and electrocardiogram of all patients during catheterization surgery.According to whether cardiovascular events occurred in patients with peritoneal dialysis more than 6 months after catheterization in our hospital,they were divided into cardiovascular event group and non-cardiovascular event group to discuss the risk factors of cardiovascular events and their survival rate;Then select patients with diabetes mellitus from the overall,according to whether patients with peritoneal dialysis more than 6 months after catheterization in our hospital have cardiovascular events,they are divided into cardiovascular event group and non-cardiovascular event group to discuss peritoneal dialysis combined with diabetes Of patients have cardiovascular events and risk factors that affect their survival.As of June 2019,those who had undergone peritoneal dialysis for more than 6 months after peritoneal dialysis had cardiovascular events,including cardiovascular infarction,heart failure,angina pectoris,arrhythmia,death due to dissection of arterial dissection,Death due to cardiovascular surgery,etc.Results:1.A total of 183 patients with peritoneal dialysis who met the inclusion criteria of this study,with a median follow-up of 24(10.2,37.8)months,55 patients with cardiovascular events(30.05%)and 128 patients without cardiovascular events(69.95%).According to the statistical results,34 cases of heart failure(61.81%),7cases of angina pectoris(12.73%),6 cases of myocardial infarction(10.91%),6 cases of arrhythmia(10.91%),and 2 other cases(3.64%).A total of 80 patients with diabetes mellitus were included in this study,with a median follow-up of 24(10.2,37.8)months,35 cases of cardiovascular events(48.75%),and 45 cases of no cardiovascular events(51.5%);according to statistics The results were as follows: 24 cases of heart failure(68.57%),4 cases of angina pectoris(11.43%),4 cases of myocardial infarction(11.43%),and 3 cases of arrhythmia(8.57%).2.In this study,there were 119 males and 64 females,with an average age of48.01±8.91 years and a median dialysis age of 24(10.2,37.8)months.The primary disease included 77 cases of chronic glomerulonephritis(42.08%),62 cases of diabetic nephropathy(33.88%),23 cases of hypertensive renal damage(12.57%),and21 others(11.48%).3.Compared with the non-cardiovascular event group,the proportion of patients with cardiovascular event group complicated with diabetes and the rate of urea nitrogen,BNP,heart valve calcification were higher,and the albumin and hemoglobin levels were lower,the difference was statistically significant(P<0.05);There is no statistically significant difference in other aspects(P>0.05).Multivariate logistic regression analysis showed that the occurrence of cardiovascular events in patients with peritoneal dialysis was positively correlated with the history of diabetes,urea nitrogen,BNP and valve calcification.The occurrence of cardiovascular events in patients with peritoneal dialysis was negatively correlated with albumin and hemoglobin.4.Among patients with peritoneal dialysis and diabetes,compared with non-cardiovascular event group,patients with cardiovascular event group had higherBNP and heart valve calcification rate,lower albumin and left ventricular ejection fraction,the difference was statistically significant(P<0.05);There was no statistically significant difference in other aspects(P>0.05).Multivariate logistic regression analysis showed that the occurrence of cardiovascular events in patients with peritoneal dialysis and diabetes was positively correlated with BNP and valve calcification.The occurrence of cardiovascular events in patients with peritoneal dialysis and diabetes was negatively correlated with albumin and left ventricular ejection fraction.5.Among the 183 patients in this study,the one-,two-,and three-year survival rates of patients with cardiovascular events(n = 55)were 90.91%,85.45%,and78.18%,which were significantly lower than those of non-cardiovascular events((n =128)The survival rates of the patients were 97.66%,93.75%,and 86.72%,and Kaplan-Meier survival curves showed statistically significant differences(P <0.05).A total of 80 patients with diabetes were included in this study.The one-,two-,and three-year survival rates of patients with cardiovascular events(n = 35)were85.71%,82.86%,and 74.29%,which were significantly lower than those of non-cardiovascular events.The survival rates of patients in the group(n = 45)were93.33%,88.89%,and 82.22%.Kaplan-Meier survival curves showed statistically significant differences(P <0.05).6.In this study,183 peritoneal dialysis patients were taken as the research object.The study variables were survival time and outcome(death),and the independent variables were history of diabetes,albumin,hemoglobin,BNP,heart valve calcification and other factors.Cox regression analysis was used to determine the risk factors of survival rate.As a result,albumin,heart valve calcification,and history of diabetes were risk factors affecting the survival rate of peritoneal dialysis patients.Multivariate Cox regression analysis showed that albumin and heart valve calcification were independent risk factors affecting the survival rate of patients with peritoneal dialysis.In this study,80 patients with peritoneal dialysis and diabetes were taken as the research object.The study variables were survival time and outcome(death),and theindependent variables were albumin,BNP,left ventricular ejection fraction,and heart valve calcification.Univariate Cox regression analysis was used to determine the risk factors for survival rate.The results found that albumin and heart valve calcification were risk factors affecting the survival rate of patients with peritoneal dialysis and diabetes.Multivariate Cox regression analysis showed that heart valve calcification was an independent risk factor affecting the survival rate of patients with peritoneal dialysis and diabetes.Conclusion:1.The incidence of cardiovascular events is higher in patients with peritoneal dialysis,with heart failure being the most common.2.Diabetes,urea nitrogen,albumin,hemoglobin,BNP,and heart valve calcification are independent risk factors for cardiovascular events in peritoneal dialysis patients.Albumin,BNP,left ventricular ejection fraction,and heart valve calcification are independent risk factors for cardiovascular events in patients with peritoneal dialysis and diabetes.3.Albumin and heart valve calcification are independent risk factors that affect the survival rate of patients with peritoneal dialysis.Heart valve calcifications are independent risk factors that affect the survival rate of patients with peritoneal dialysis and diabetes. |
PDF Full Text Request